Dropout from outpatient mental health care: results from the Israel National Health Survey.

OBJECTIVES: To examine the dropout rates from outpatient mental health treatment in the general medical and mental health sectors and to identify the predictors of dropout.
METHOD: The study population was extracted from the Israel National Health Survey. The analysis was related to 12-month service utilization for mental health reasons.
RESULTS: The total dropout rate from mental health treatment was 24%, but differed between sectors. The dropout rate from general medical care was 32, and 22% from mental health care. In the general medical care sector, 30% ended treatment within two visits, while only 10% did so in the mental health-care sector. Chronic health condition, but not severity of psychiatric disorder, predicted dropout in the mental health sector. DISCUSSION: The higher rate of early dropout in general medical care may be related to the brevity of general medical visits and/or the inexperience of primary care physicians, which limits the opportunity to develop patient-physician rapport. Providers of services will have to promote education programs for GPs and allocate proper time to psychiatric patients. LIMITATION: The sample, although based on a national representative cohort, was small and limited the number of independent variables that could be examined.